Basic Information
| Provider Information | |||||||||
| NPI: | 1619937786 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GREER | ||||||||
| FirstName: | TODD | ||||||||
| MiddleName: | BLAKE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | GREER | ||||||||
| OtherFirstName: | TODD | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2001 BUTTERFIELD RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | DOWNERS GROVE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605151069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6307252730 | ||||||||
| FaxNumber: | 8442055691 | ||||||||
| Practice Location | |||||||||
| Address1: | 2775 OLD MILTON PKWY | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | ALPHARETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300092212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6787818201 | ||||||||
| FaxNumber: | 6787818202 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2006 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 042261 | GA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 202K00000X | 042261 | GA | N | Allopathic & Osteopathic Physicians | Phlebology | 2086S0129X | 036109001 | IL | N | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | 2086S0129X | 042261 | GA | N | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
No ID Information.